Treatment of Localized Granuloma Annulare Typically Found on the Lateral or Dorsal Surfaces of the Hands and Feet
Localized granuloma annulare is the predominant presentation of this condition. It typically appears on the lateral or dorsal surfaces of the hands and feet, and management decisions depend on whether the patient is seeking active treatment.
Clinical Scenario
The localized form of granuloma annulare accounts for the large majority of cases and is characteristically found on the lateral or dorsal surfaces of the hands and feet — distinguishing it from the disseminated form, which is widespread.
Treatment Approach
For patients who request treatment, management options involve corticosteroid-based approaches as well as certain procedural interventions. Patients should be counselled that any of these options carries a risk of scarring and skin atrophy. The complete selection and application of these options is outlined in the full protocol.
Treatment Goal
Resolution of the granuloma annulare skin lesions.
References
- The two most common types of granuloma annulare are localized, which typically is found on the lateral or dorsal surfaces of the hands and feet; and disseminated, which is widespread.
- The localized form of granuloma annulare composes 75 percent of cases.
- For patients insisting on treatment, options include intralesional corticosteroid injection with 2.5 to 5.0 mg per mL triamcinolone (Aristocort) into the elevated border, topical corticosteroids under occlusion, cryotherapy, and electrodesiccation.
- Options for treatment of localized granuloma annulare include liquid nitrogen, injected steroids, and topical steroids.
- Liquid nitrogen, injected steroids, or topical steroids under occlusion have been recommended for treatment of localized disease.
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